<!DOCTYPE html>
<html>

	<head>
		<meta charset="utf-8" />
		<title>Inscription Stagiaire</title>
	</head>
	
	<body>
		
		<h1>Inscription Stagiaire</h1>
		
		<form method="post" action="">
		
		<fieldset>
		
			<legend>Informations du Stagiaire </legend>
				
				<table>
					<tr>
						<td>Civilité :</td>
						<td><input type="radio" name="stagiairecivilite" value="mme" /> <label>Mme</label>
							<input type="radio" name="stagiairecivilite" value="mr" /> <label>Mr</label></td>
					</tr>
					<tr>
						<td>Nom :</td>
						<td><input type="text" name="stagiairenom" size="30" maxlength="50" /></td>
					</tr>
					<tr>
						<td>Prénom :</td>
						<td><input type="text" name="stagiaireprenom" size="30" maxlength="50" /></td>
					</tr>
					<tr>
						<td>Adresse :</td>
						<td><input type="text" name="stagiaireadresse" size="30" maxlength="50" /></td>
					</tr>
					<tr>
						<td>Code Postal :</td>
						<td><input type="text" name="stagiairecodepostal" size="5" maxlength="5" /></td>
					</tr>
					<tr>
						<td>Ville :</td>
						<td><input type="text" name="stagiaireville" size="30" maxlength="50" /></td>
					</tr>
					<tr>
						<td>Téléphone :</td>
						<td><input type="tel" name="stagiairetelephone" size="10" maxlength="10" /></td>
					</tr>
					<tr>
						<td>Email :</td>
						<td><input type="text" name="stagiaireemail" size="30" maxlength="50" /></td>
					</tr>
					
				</table>	
				
		</fieldset>
		
		<input type="submit" value="Enregistrer" />
		
		</form>
	
	</body>


</html>